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TOBIAS VETERINARY SURGERY > THORAX, PERICARDIUM: 104, 105, 107 > Flashcards

THORAX, PERICARDIUM: 104, 105, 107 Flashcards

1
Q

What lung protdrude more cranially?

A

the left cranial lobe compared to the right cranial

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2
Q

arterial supply of the dorsolateral skin of the thorax

A

thoracodorsal artery

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3
Q

surgical access to ICS cranial to 5 (not comprised)

A

skin, latissimus dorsally + deep pectoralis ventrally, scalenus, (rectus toracis very ventral), serratus dorsalis+ serratus ventralis, ICS muscle

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4
Q

origin of the intercostal artery

A

the first 3-4 are branches of the thoracic vertebral artery

remainder direct brances from aorta

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5
Q

what vessel always accompany dorsal the transverse thoracic muscle?

A

internal thoracic artery (arise fromo left and right subclavian arteries)

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6
Q

in sternotomy closure is preferred to use a figure of eight or a double loop cerclage?

A

figure of 8

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7
Q

what breeds are predisposed to pectus excavatum?

A

bengala and burmese. cause of a shortened or hypoplastic diaphragm

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7
Q

what breeds are predisposed to pectus excavatum?

A

bengala and burmese. cause of a shortened or hypoplastic diaphragm

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8
Q

name some of the muscles that could serve as flaps in the thoracic region

A

latissimus dorsi, external abdominal oblique, transversus abdominis, diaphragm

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9
Q

surgical access caudal to ICS 5 (included)

A

latissimus dorsi, only a small portion ventrally of pectoralis deep. serratus dorsalis and ventralis (not until last ribs), NO scalenus, YES external abdominal oblique ventrally

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10
Q

physiologic content of pleural fluid in dogs and cats

A

dogs: 0,1 ml/kg
cats: 0,3 ml/kg

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11
Q

lymphatic drainage of the thorax

A

VISCERAL NODES:
mediastinal: cranial mediastinum, hearth surface
bronchial: pulmonary + tracheobronchial

PARIETAL NODES:
ventral center: right and left sternal (or single)
dorsal center: aortic thoracic nodes, inconsistent in dimensions and presence (25% of dogs)

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12
Q

cisterna chili anatomic landmarks

A

ventral to 1-4 lumbar vertebrae

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13
Q

anatomic differences in thoracic duct beetween dogs and cats

A

dorsolateral to aorta RIGHT in dogs, LEFT in cats. crosses to the left in dogs at 6-7 thoracic vertebra.

boths terminates in ext jugular vein or jugosubclavian angle

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14
Q

pleural fluid classification

A

trasudate: <3 PRO, <1015 PS, < 1500 NCC/microlitro

modif trasudate: 2,5-5 PRO, 1015-1025 PS: 1500-7000 NCC/microlitro

exudate: > 3 PRO, >1025 PS, >7000 NCC/microlitro

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15
Q

how to diagnose a chylous effusion

A

triglyceride effusion > triglyceride serum

cholesterol effusion < cholesterol serum

detection of chylomicrons

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16
Q

what is pseudochylous?

A

not descrubed in pets, in human medicine when cholesterol effusion> cholesterol serum and viceversa trygliceride.

17
Q

frequently present bacteria in septic pleural exudate

A

nocardia and actinomyces. usually are more frequent anaerobes

18
Q

common RX finding in a dog with lung lobe torsion

A

increased opacity, up to 87% have the emphisematous appearance on the malpositioned LL

19
Q

thoracostomy tube placement anatomic landmarks

A

skin incision: 10-11 ICS, insertion 7-8 ICS

20
Q

what structures can be approached with only a monolateral toracotomy?

A

PDA, PRAA: 4-5 LEFT
PULMONIC VALVE: 4 LEFT
MIDDLE LUNG LOBE: 5 RIGHT
CRANIAL VENA CAVA: 4 right commonly, but also 4 left
THORACIC DUCT: 8-9-10-11 right dog, left feline.

20
Q

what structures can be approached with only a monolateral toracotomy?

A

PDA, PRAA: 4-5 LEFT
PULMONIC VALVE: 4 LEFT
MIDDLE LUNG LOBE: 5 RIGHT
CRANIAL VENA CAVA: 4 right commonly, but also 4 left
THORACIC DUCT: 8-9-10-11 right dog, left feline.

21
Q

surgical access to perform a LN injection and simoultaneously thoracic duct ligation

A

right lateral paracostal (LN) + right ICS

21
Q

surgical access to perform a LN injection and simoultaneously thoracic duct ligation

A

right lateral paracostal (LN) + right ICS

22
Q

reported percentage of success with pericardiectomy+thoracic duct ligation

A

80-100%

23
Q

septic effusion lactate, glucose and pH

A

usually lactate >200 IU/L. glucose <1,68 mmol/L, pH <6.9

24
Q

time to pleural drain removal

A

4-8 days. usually removed when it produces less than 3-5 o less than 2 ml/Kg/day

25
Q

common neurological disorder associated with tymoma in dogs

A

up to 47% develop myasthenia gravis

26
Q

where does the pericardium attaches in the thorax?

A

base of the hearth (Aortic arch, brachiocephalic trunk, left atrium, interatrial groove)

caudoventral apex anchors ventrally on to muscolar insertion of the diaphragm

27
Q

describe the pericardium vascular supply

A

-paired pericardial branches of the internal thoracic artery (course caudoventrally on LV aspect of the pericardium).

-perciardiocophrenic arteries (from internal thoracic, supply dorsolateral aspect of the pericardium

28
Q

describe the sequelae of event that occurs after cardiac tamponade

A

1) cardiac output decrease, systemic venous pressure increase
2) activation of compensatory neurohumoral response
3) RAAS activation
4) sympatethic stimulation
5) catecholamine release

29
Q

what does the NON stretching of the right atrium determine

A

lack of releasing of atrial natiouretic peptide. id does not counteract the action of RAAS. as a consequence there will be portal hypertensions and venous hypertension

30
Q

descrive the mechanism at the base of pulsus paradoxus

A

1) during inspiration pericardial and right atrium pressure decrease
2) inspiration -> higher venous flow to RA
3) interventricular septum shift to the left
4) inspiration -> left hearth output and arterial pressure decrease
5) variation in systolic pressure (>10 mmHg) and pulse regarding to the phase of breathing

31
Q

what patologies can cause pulsus paradoxus other than cardiac tamponade?

A

-restrictive cardiomiopaty
-obstructive lung desease
-hypovolemic shock

32
Q

ICS space access for vena cava stricture surgery

A

Right sided 5-6th ICS

33
Q

What is a possible fungal infection to the pericardium?

A

coccidioides immitis (southern USA)

34
Q

most 2 frequent causes of pericardial effusion

A

1) idiopathic pericardial effusion
2) neoplasia (hemangio, hearth base, pericardium, chemodectoma, mesotelima)

35
Q

ICS space for thoracocentesis

A

right (avoid main coronary arteries) 5-6 ICS

36
Q

description of transdiaphragmatic subxiphoid approach

A

Duprè 2001

37
Q

what is the kussmaul sign

A

persistent increase in jugular venous pressure during inspiration

TOBIAS VETERINARY SURGERY (20 decks)

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